Bronchoscopic Coil Treatment for Patients with Severe Emphysema: A Meta-Analysis

被引：47

作者：

Slebos, Dirk-Jan ^{[1
]}

Hartman, Jorine E. ^{[1
]}

Klooster, Karin ^{[1
]}

Blaas, Stefan ^{[2
]}

Deslee, Gaetan ^{[9
]}

Gesierich, Wolfgang ^{[3
]}

Hetzel, Juergen ^{[4
]}

Hetzel, Martin ^{[5
]}

McNulty, William ^{[12
,13
,14
]}

Kemp, Samuel V. ^{[12
,13
,14
]}

Kessler, Romain ^{[10
]}

Leroy, Sylvie ^{[11
]}

Stanzel, Franz ^{[6
]}

Witt, Christian ^{[7
]}

Zoumot, Zaid ^{[12
,13
,14
,15
]}

Herth, Felix J. F. ^{[8
]}

Shah, Pallav L. ^{[12
,13
,14
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Pulm Dis, NL-9700 RB Groningen, Netherlands

[2] Donaustauf Hosp, Ctr Pneumol, Donaustauf, Germany

[3] Asklepios Fachkliniken Munchen Gauting, Comprehens Pneumol Ctr Munich, Gauting, Germany

[4] Univ Hosp Tubingen, Tubingen, Eritrea

[5] Krankenhaus vom Roten Kreuz Bad Cannstatt, Stuttgart, Germany

[6] Lungenklin Hemer, Hemer, Germany

[7] Campus Charite Mitte, Berlin, Germany

[8] Heidelberg Univ, Dept Pneumol & Crit Care Med, Thoraxklin, Translat Lung Res Ctr Heidelberg, Heidelberg, Germany

[9] Univ Hosp Reims, Dept Pulm Med, Reims, France

[10] Univ Hosp Strasbourg, Dept Pulm Med, Strasbourg, France

[11] Univ Hosp Nice, Dept Pulm Med, Nice, France

[12] Royal Brompton & Harefield NHS Fdn Trust, Natl Inst Hlth Res, Resp Biomed Res Unit, London, England

[13] Univ London Imperial Coll Sci Technol & Med, London, England

[14] Chelsea & Westminster Hosp, London, England

[15] Cleveland Clin Abu Dhabi, Abu Dhabi, U Arab Emirates

来源：

RESPIRATION | 2015年 / 90卷 / 02期

关键词：

Chronic obstructive pulmonary disease; Emphysema; Bronchoscopic lung volume reduction; LUNG-VOLUME-REDUCTION; OBSTRUCTIVE PULMONARY-DISEASE; MINIMAL IMPORTANT DIFFERENCE; MULTICENTER TRIAL; THERAPY; STANDARDIZATION;

D O I：

10.1159/000431384

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

Background: Bronchoscopic coil treatment has been shown to improve pulmonary function, exercise capacity, and quality of life in patients with severe emphysema. Objectives: To perform a meta-analysis of the results of four independent European clinical trials investigating this coil therapy for emphysema. Methods: Data on all patients included in the four European clinical trials were analyzed for efficacy and safety outcomes. Results: A total of 2,536 coils were placed during 259 procedures in 140 patients. A total of 37 chronic obstructive pulmonary disease exacerbations and 27 pneumonias were recorded as serious adverse events up to 1 year after treatment. The pneumothorax rate was 6.4%. Both 6 and 12 months after treatment, significant (all p < 0.001) improvements were observed for: forced expiratory volume in 1 s [+0.08 liters (+/- 0.19) and +0.08 liters (+/- 0.21)], residual volume [RV; -510 ml (+/- 850) and -430 ml (+/- 720)], 6-min walking distance [6MWD; +44.1 m (+/- 69.8) and +38.1 m (+/- 71.9)], and St. George's Respiratory Questionnaire score [SGRQ; -9.5 points (+/- 14.3) and -7.7 points (+/- 14.2)]. No differences in any outcome measures were observed between heterogeneous and homogeneous emphysema patients. Only a high baseline RV was found to be an independent predictor of successful treatment. Conclusions: Bronchoscopic coil treatment improves pulmonary function, 6MWD, and quality of life in patients with severe emphysema up to 1 year after treatment, independent of the distribution of the disease. (C) 2015 S. Karger AG, Basel

引用

页码：136 / 145

页数：10

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